<!DOCTYPE html>
<html>

<head>
    <meta charset="utf-8">
    <title>layui</title>
    <meta name="renderer" content="webkit">
    <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
    <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
    <link rel="stylesheet" href="../lib/layui-v2.6.3/css/layui.css" media="all">
    <link rel="stylesheet" href="../css/public.css" media="all">
</head>
<style>

</style>

<body>
    <div class="layuimini-container">
        <div class="layuimini-main">

            <fieldset class="layui-elem-field layui-field-title" style="margin-top: 20px;">
                <legend>优目系统验镜信息录入</legend>
            </fieldset>

            <form class="layui-form layui-form-pane" action="">
                <!-- 远近视力 -->
                <blockquote class="layui-elem-quote layui-text">
                    远近视力
                </blockquote>
                <div>
                    <!-- 远用视力 -->
                    <div class="layui-form-item">
                        <label class="layui-form-label">远用视力</label>
                        <div class="layui-input-inline">
                            <input type="radio" name="isGlasses1" value="裸眼" title="裸眼" checked="">
                            <input type="radio" name="isGlasses1" value="戴镜" title="戴镜">
                        </div>
                        <label class="layui-form-label">OD</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <div class="layui-inline">
                            <label class="layui-form-label">针孔视力</label>
                            <div class="layui-input-inline">
                                <input type="text" name="number" autocomplete="off" class="layui-input">
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="layui-form-label">OS</label>
                            <div class="layui-input-inline">
                                <input type="text" name="number" autocomplete="off" class="layui-input">
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="layui-form-label">针孔视力</label>
                            <div class="layui-input-inline">
                                <input type="text" name="number" autocomplete="off" class="layui-input">
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="layui-form-label">OU</label>
                            <div class="layui-input-inline">
                                <input type="text" name="number" autocomplete="off" class="layui-input">
                            </div>
                        </div>
                    </div>
                    <!-- 近用视力 -->
                    <div class="layui-form-item">
                        <label class="layui-form-label">近用视力</label>
                        <div class="layui-input-inline">
                            <input type="radio" name="isGlasses2" value="裸眼" title="裸眼" checked="">
                            <input type="radio" name="isGlasses2" value="戴镜" title="戴镜">
                        </div>
                        <label class="layui-form-label">OD</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <div class="layui-inline">
                            <label class="layui-form-label">OS</label>
                            <div class="layui-input-inline">
                                <input type="text" name="number" autocomplete="off" class="layui-input">
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="layui-form-label">OU</label>
                            <div class="layui-input-inline">
                                <input type="text" name="number" autocomplete="off" class="layui-input">
                            </div>
                        </div>
                    </div>
                </div>

                <!-- 旧镜信息 -->
                <blockquote class="layui-elem-quote layui-text">
                    旧镜信息
                </blockquote>
                <div>
                    <div class="layui-form-item">

                        <div class="layui-input-block">
                            <div>
                                <input type="radio" name="haveGlasses1" value="框架" title="框架" checked="">
                                <input type="radio" name="haveGlasses1" value="隐形" title="隐形">
                            </div>
                        </div>
                        <hr class="layui-border-blue">
                        <fieldset class="layui-elem-field layui-field-title" style="margin-top: 30px;">
                            <legend>眼别（右眼）</legend>
                        </fieldset>

                        <label class="layui-form-label">球镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">柱镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">轴向</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">瞳距</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">ADD</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>

                    <hr class="layui-border-blue">
                    <div class="layui-form-item">
                        <fieldset class="layui-elem-field layui-field-title" style="margin-top: 30px;">
                            <legend>眼别（左眼）</legend>
                        </fieldset>

                        <label class="layui-form-label">球镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">柱镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">轴向</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">瞳距</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">ADD</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>

                    <hr class="layui-border-blue">
                    <div class="layui-form-item layui-form-text">
                        <label class="layui-form-label">验光师建议</label>
                        <div class="layui-input-block">
                            <textarea placeholder="请输入内容" class="layui-textarea"></textarea>
                        </div>
                    </div>
                </div>


                <!-- 交叉柱镜结果 -->
                <blockquote class="layui-elem-quote layui-text">
                    交叉柱镜结果
                </blockquote>

                <div>
                    <div class="layui-form-item">
                        <fieldset class="layui-elem-field layui-field-title" style="margin-top: 30px;">
                            <legend>眼别（右眼）</legend>
                        </fieldset>
                        <label class="layui-form-label">球镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">柱镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">轴向</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">单眼视力</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                    <hr class="layui-border-blue">
                    <div class="layui-form-item">
                        <fieldset class="layui-elem-field layui-field-title" style="margin-top: 30px;">
                            <legend>眼别（左眼）</legend>
                        </fieldset>
                        <label class="layui-form-label">球镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">柱镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">轴向</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">单眼视力</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">双眼视力</label>
                        <div class="layui-input-block">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                </div>
                <blockquote class="layui-elem-quote layui-text">
                    完全矫正
                </blockquote>
                <div>
                    <div class="layui-form-item">
                        <fieldset class="layui-elem-field layui-field-title" style="margin-top: 30px;">
                            <legend>眼别（右眼）</legend>
                        </fieldset>
                        <label class="layui-form-label">球镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">柱镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">轴向</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>

                        <label class="layui-form-label">瞳距</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">远视力</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                    <hr class="layui-border-blue">
                    <div class="layui-form-item">
                        <fieldset class="layui-elem-field layui-field-title" style="margin-top: 30px;">
                            <legend>眼别（左眼）</legend>
                        </fieldset>
                        <label class="layui-form-label">球镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">柱镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">轴向</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">瞳距</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">远视力</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">双眼视力</label>
                        <div class="layui-input-block">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                </div>



                <!-- 配镜处方 -->
                <blockquote class="layui-elem-quote layui-text">
                    配镜处方
                </blockquote>
                <div>
                    <div class="layui-form-item">
                        <fieldset class="layui-elem-field layui-field-title" style="margin-top: 30px;">
                            <legend>眼别（右眼）</legend>
                        </fieldset>
                        <label class="layui-form-label">球镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">柱镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">轴向</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>

                        <label class="layui-form-label">瞳距</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">ADD</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">瞳高</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">远视力</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">近视力</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                    <hr class="layui-border-blue">
                    <div class="layui-form-item">
                        <fieldset class="layui-elem-field layui-field-title" style="margin-top: 30px;">
                            <legend>眼别（左眼）</legend>
                        </fieldset>
                        <label class="layui-form-label">球镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">柱镜</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">轴向</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">瞳距</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">ADD</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">瞳高</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">远视力</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                        <label class="layui-form-label">近视力</label>
                        <div class="layui-input-inline">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">双眼视力</label>
                        <div class="layui-input-block">
                            <input type="text" name="number" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                </div>
                <hr class="layui-border-blue">
                <!-- 验光师建议 -->
                <div class="layui-form-item layui-form-text">
                    <label class="layui-form-label">验光师建议</label>
                    <div class="layui-input-block">
                        <textarea placeholder="请输入内容" class="layui-textarea"></textarea>
                    </div>
                </div>


                <div class="layui-form-item">
                    <button class="layui-btn" lay-submit="" lay-filter="demo2">提交</button>
                </div>
            </form>
        </div>
    </div>

    <script src="../lib/layui-v2.6.3/layui.js" charset="utf-8"></script>
    <!-- 注意：如果你直接复制所有代码到本地，上述js路径需要改成你本地的 -->
    <script>
        layui.use(['form', 'layedit', 'laydate'], function() {
            var form = layui.form,
                layer = layui.layer,
                layedit = layui.layedit,
                laydate = layui.laydate;

            //日期
            laydate.render({
                elem: '#date'
            });
            laydate.render({
                elem: '#date1'
            });

            //创建一个编辑器
            var editIndex = layedit.build('LAY_demo_editor');

            //自定义验证规则
            form.verify({
                title: function(value) {
                    if (value.length < 5) {
                        return '标题至少得5个字符啊';
                    }
                },
                pass: [
                    /^[\S]{6,12}$/, '密码必须6到12位，且不能出现空格'
                ],
                content: function(value) {
                    layedit.sync(editIndex);
                }
            });

            //监听指定开关
            form.on('switch(switchTest)', function(data) {
                layer.msg('开关checked：' + (this.checked ? 'true' : 'false'), {
                    offset: '6px'
                });
                layer.tips('温馨提示：请注意开关状态的文字可以随意定义，而不仅仅是ON|OFF', data.othis)
            });

            //监听提交
            form.on('submit(demo1)', function(data) {
                layer.alert(JSON.stringify(data.field), {
                    title: '最终的提交信息'
                })
                return false;
            });

            //表单初始赋值
            form.val('example', {
                "username": "贤心" // "name": "value"
                    ,
                "password": "123456",
                "interest": 1,
                "like[write]": true //复选框选中状态
                    ,
                "close": true //开关状态
                    ,
                "sex": "女",
                "desc": "我爱 layui"
            })


        });
    </script>

</body>

</html>